Ischemic Tolerance Of Obstructive Jaundice Liver And Hepatectomy In Rats With Portal Trial Clamping

Objective To investigate the maximun tolerance of obstructive jaundice liver in rat to undergo hepatectomy with portal trial clamping (PTC) and without portal blood bypass. Methods Three days later, 72 wistar rats that underwent the biliary obstructive operatioin, were randomly divided into six groups according to the hepatocholangioenterostomy and the duration of PTC time. In group A, B and C (on each group, n=12), PTC time were 10, 15 and 20 min respectively; in group D, one-third liver was resected; in group E, PTC time was 10 min and one-third liver was resected; in group F, PTC time was 15 min and one-third liver was resected. Liver functions including transaminase (ALT), albumen (Alb), the total bilirubin (TB), XOD and PCNA were tested during the 1th, 4th and 7th days respectively after the operation. When operation was finished, 10% liver parenchyma was taken and preserved in formalin and liquid nitrogen to test the expression of PCNA and the content of XOD. In each group, the survival time was counted with 1 week. Result (1)Co mpared with the control group, the level of ALT in other groups significantly unproved on the 1th day after the operation (P<0.05); on the 4th and 7th days, the lever of ALT in group F and C was significantly higher than that in A, B, D and E group (P<0.05). The serum levers of albumens (Alb) in group C and F were significantly lower than that in group A, B, E and D (P<0.05) on the 4th and 7th day after the operation. The lever of TB increased on the 1st day after the operation, but there were no difference between the each levels from groups; the lever of TB from group C and F was higher than that from group A, B, D and E (P<0.05) on the 4th and 7th day; the levers of TB on the 4th and 7th days from group A, B, D and E were significantly lower than that on the 1st day from that groups.(2) The content of XOD from group D was significantly higher than that from normal rats (PO.05), and the increasing lever was go on with the obstructive time. The content of XOD was significantly higher in group A, B, C, E and F than that in group D (PO.05); and the content was higher in group C than that in group A, B, D and E (PO.05). (3)Pathology changes: Oedema and fatty denaturation in liver cell was present in group A and D; in group A, scattered acidophilic necrosis was present, and the changes of oedema almost recovered to the normal on the 7th day; in group B, the spotty necrosis was present with the infiltration of inflammatic cells in the portal area; in the group C and F, patch and bridge necrosis was present with severious infiltration of inflammatic cells in the portal area, and the necrosis could be found until 7th day with the apperence of cirrhosis. (4)PCNA expression: Compared with normal liver, the expression of PCNA was lower and the peak value delayed in experimental groups; in group A and D, the expression was higher on the 4th day than that on the 1st day (P<0.05); in group C and F, the expression was lower than that in other groups on the 7th day (P<0.05). (5)One week survival: The survival rate was lower in group C and F than that in group A, B, D and E (PO.05), but there were no difference between the groups of A, B, D and E (P>0.05). Conclusion For the obstruction jaundice rats without portal blood bypass, the safe time of PTC under normal temperature should be 15 min, the safe time of PTC with hepatic resection should be 10 min.